Healthcare Provider Details

I. General information

NPI: 1467370007
Provider Name (Legal Business Name): REGEN PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 W 1940 S STE 100
LOGAN UT
84321-6978
US

IV. Provider business mailing address

4725 COLLEGE PARK STE 200
SAN ANTONIO TX
78249-3570
US

V. Phone/Fax

Practice location:
  • Phone: 833-734-3679
  • Fax: 833-734-3679
Mailing address:
  • Phone: 210-667-7920
  • Fax: 210-667-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL C CASTELLA
Title or Position: MANAGER
Credential: PHD
Phone: 210-667-7920